tag:blogger.com,1999:blog-12660458.post111900880230538761..comments2023-09-01T10:33:09.297-04:00Comments on Pulmonary Roundtable: Conclusion to "26 year old with asthma"Unknownnoreply@blogger.comBlogger5125tag:blogger.com,1999:blog-12660458.post-1119383451536612862005-06-21T15:50:00.000-04:002005-06-21T15:50:00.000-04:00Actually, the serologic tests have outstanding spe...Actually, the serologic tests have outstanding specificity with horrible sensitivity. We checked them after the CT scan, and they were negative, but it didn't change our approach.Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1119381386498077532005-06-21T15:16:00.000-04:002005-06-21T15:16:00.000-04:00If the cyst were due to Echinoccocus it would stil...If the cyst were due to Echinoccocus it would still be fairly easy to diagnose on path even after albendazole. The remnants of the scoleces would be easily identifiable. So even though I'd love to sound smart and have gotten the hidatid cyst Dx, it seems less likely... If memory serves, there are several serological tests for Echinococcus, including ELISA and PCR for peripheral blood but I think ELISA turns negative with treated or "old" cysts.Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1119355393295807732005-06-21T08:03:00.000-04:002005-06-21T08:03:00.000-04:00Serum immunoglobulins were normal--I actually chec...Serum immunoglobulins were normal--I actually checked those after his initial visit before the CT scan. Best I can put this together now is that he had some parasitic infection in the past (still possible echinococcus) that had resolved on its own prior to his presentation, or alternatively we supressed/killed more than we anticipated with the Albendazole prior to resection. No micro isolates have come up yet. <BR/><BR/>A literature search for eosinophilic lung abscess (excluding all papers regarding CEP, AEP, etc) comes up with one hit in a regional journal from India in 1967. If only I could get that paper....Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1119284981804163322005-06-20T12:29:00.000-04:002005-06-20T12:29:00.000-04:00This was very interesting though anti-climatic. Wi...This was very interesting though anti-climatic. With such a focal lesion it looks like a lower resp. tract infection with focal airway damage and a ball-valve effect with progressive dilation and destruction: the ultimate bronchiectasis. <BR/>With focal (now resected) disease she should do very well. <BR/>I'd still check him for causes of bronchiectasis (e.g. check immunoglobulins) though it is less likely that he had a systemic process causing only localized disease.<BR/>Any unusual micro isolates?Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1119280874554438812005-06-20T11:21:00.000-04:002005-06-20T11:21:00.000-04:00Very interesting (if anti-climatic). Do you think...Very interesting (if anti-climatic). Do you think he had a resp. tract infection with focal airway damage and intermitent obstruction (like a ball-valve effect) with secretions and progressive destruction and focal dilation?<BR/>If that is the case he should do well as the process was very focal.<BR/>Any unusual micro isolates?Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.com